AB1816-HPR RELIABILITY AND VALIDITY OF THE LIE-TO-SIT-TO-STAND-TO-WALK TRANSFER TEST IN TOTAL KNEE ARTHROPLASTY
Authors: B. Unver, K. S. Kacmaz, V. Karatosun
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Total knee arthroplasty (TKA) is the gold-standard procedure for end-stage knee osteoarthritis, however, some residual problems may still continue and cause a variety of dysfunctions, such as pain, impaired strength, proprioception, postural instability, dynamic balance, and gait deficiencies [1]. Falls are the most frequent cause of injuries in elderly people, accounting for 90% of hip and wrist fractures and 60% of head injuries [2] requiring expensive and difficult procedures such as fracture surgeries and arthroplasties [3]. The most frequent cause of falling was transfer activities while shifting body weight which accounted for 41% of falls [2] especially getting up from bed and walking to the bathroom [2,4,5]. Additionally, the three major classes of activities—walking, sitting down, and standing—were the most common precipitants of falls. These findings emphasize the need to target each of these activities in fall risk assessment and prevention strategies [2,5]. The Lie-to-Sit-to-Stand-to-Walk Transfer Test (LSSWT) incorporates a multitask approach to measure complicated transfer abilities in older people. However, there is no study investigating the reliability and validity of the LSSWT in TKA patients. <h3>Objectives</h3> The aim of the study is to determine the reliability, validity, and minimal clinically important difference (MCID) of the LSSWT in patients with TKA. <h3>Methods</h3> Twenty-one patients with TKA were included in the study. The LSSWT, the Timed Up and Go Test (TUG), and the Hospital for Special Surgery (HSS) were administered to the patients. Patients rested between the tests for an hour to prevent fatigue. <h3>Results</h3> The mean age was 68.1 ± 2.59 years and the mean HSS Knee Score was 85.43± 3.47. The relative (ICC coefficient) and absolute (SEM and SRD95) reliability values were 0.88, 1.21, and 3.33 respectively. The Spearman correlation coefficient of the LSSWT with the TUG was 0.63. <h3>Conclusion</h3> The LSSWT has excellent reliability and high validity in evaluating fall risk and complex dynamic balance and mobility for the activities of daily living in patients with TKA. The low MCID value (3.33) shows that it is sensitive and identifies little alterations in a patient's condition over time or management strategies. Therefore, it is advisable to use the LSSWT for assessing the fall risk, dynamic balance, and mobility for living in the community, discharging, or admitting to a facility. <h3>References</h3> [1] Huber EO, Roos EM, Meichtry A, de Bie RA, Bischoff-Ferrari HA. Effect of preoperative neuromuscular training (NEMEX-TJR) on functional outcome after total knee replacement: An assessor-blinded randomized controlled trial. BMC Musculoskelet Disord [Internet]. 2015 Apr 25 [cited 2023 Jan 15];16(1):1–14. Available from: https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-015-0556-8 [2] Robinovitch SN, Feldman F, Yang Y, Schonnop R, Leung PM, Sarraf T, et al. Video capture of the circumstances of falls in elderly people residing in long-term care: an observational study. Lancet [Internet]. 2013 Jan 1 [cited 2022 Nov 19];381(9860):47. Available from:/pmc/articles/PMC3540102/ [3] Total Hip Arthroplasty or Hemiarthroplasty for Hip Fracture. New England Journal of Medicine [Internet]. 2019 Dec 5 [cited 2023 Jan 15];381(23):2199–208. Available from: https://www.nejm.org/doi/full/10.1056/NEJMoa1906190 [4] Rice LA, Ousley C, Sosnoff JJ. A systematic review of risk factors associated with accidental falls, outcome measures and interventions to manage fall risk in non-ambulatory adults. https://doi.org/103109/096382882014976718 [Internet]. 2015 Sep 1 [cited 2023 Jan 15];37(19):1697–705. Available from: https://www.tandfonline.com/doi/abs/10.3109/09638288.2014.976718 [5] Yang Y, van Schooten KS, Sims-Gould J, McKay HA, Feldman F, Robinovitch SN. Sex Differences in the Circumstances Leading to Falls: Evidence From Real-Life Falls Captured on Video in Long-Term Care. J Am Med Dir Assoc. 2018 Feb 1;19(2):130-135.e1. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.